Wednesday April 16th 2014

Types of sex addiction

Sex addiction is an ever-developing therapeutic field that treats a specific range of sexual issues. But how many people are sex addicts? And what types of sex addictions can people have?

Nearly 1/4 of a million people search for information on Google about “sex addiction” monthly. Despite some who contest the validity of this term, sex addiction clearly surpasses any other self-diagnosis for which a patient might seek therapy for a variety of out-of-control sexual urges or behaviors.

When is sexual behavior addictive?

The criteria for whether or not sexual behavior is addictive include the presence of obsession, compulsion, loss of control, and continuation in spite of negative consequences. The majority of sex addict clients that come to our Los Angeles clinic seek help to control addictive behaviors mainly related to serial infidelity, prostitute solicitation and porn. We explore with them the reasons why people have an affair or pay for sex or porn… and help them return to healthy sexuality and sexual expression.

S Fellowships and the concept of sex addiction

The concept of sex addiction has only emerged in the mid-1970s when members of Alcoholics Anonymous sought to apply the principles of 12-Steps toward their own self-defined sexual recovery. These members applied the 12-Step structure to create new support groups like Sex and Love Addicts Anonymous (S.L.A.A.), Sex Addicts Anonymous (SAA), Sexaholics Anonymous (SA), and Sexual Compulsives Anonymous (SCA) that all seemed to independently surface spontaneously within that same era. As a whole, these are known as the “S” programs or S-fellowships because they all focus on sexual recovery.

How do professionals treat sex addiction?

In 1983, Dr. Patrick Carnes published the first known book on the subject Out of the Shadows: Understanding Sexual Addiction drawing on 12-Step philosophy fused with clinical psychology. This early work became the basis for the current therapeutic field of sex addiction treatment. Later in his book Don’t Call It Love (1992), Dr. Carnes would identify 10 types of sex addiction (see below). Currently, the standard treatment for sex addiction includes assessment and consultation with a licensed therapist who is a member of The Society for the Advancement of Sexual Health (SASH) and/or a Certified Sex Addiction Therapist (CSAT). Ideally therapy for sex addiction is accompanied by participation in a peer-based recovery support group such as S-fellowship 12-Step programs.

3 levels of sex addiction

Dr. Carnes also described the three levels of sex addiction in Out of the Shadows, which correspond to varying degrees of consent.

Level One – Level One sexual behaviors include compulsive masturbation, pornography, and consensual sexual liaisons both heterosexual and homosexual.

Level Two – Level Two behaviors are illegal activities but considered as “nuisance offences,” even though they are non-consensual therefore they all involve a degree of victimization. These include flashing, voyeurism and indecent phone calls.

Level Three – Level Three behaviors are serious criminal behaviors that are dangerous and abusive, and result in serious consequences for the victims. These include child molestation, sexual abuse of vulnerable adults, and rape.

10 types of sex addiction

Following are the types of sex addiction and their characteristics.

1. Fantasy Sex - Sexually charged fantasies, relationships, and situations. Arousal depends on sexual possibility. How to stop fantasizing?

2. Seductive Role Sex - Seduction of partners.  Arousal is based on conquest and diminishes rapidly after initial contact.

3. Voyeuristic Sex - Visual arousal. The use of visual stimulation to escape into obsessive trance.

4. Exhibitionistic Sex - Attracting attention to body or sexual parts of the body. Sexual arousal stems from reaction of viewer whether shock or interest.

5. Paying for Sex - Purchasing of sexual services. Arousal is connected to payment for sex, and with time the arousal actually becomes connected to the money itself.

6. Trading Sex - Selling or bartering sex for power. Arousal is based on gaining control of others by using sex as leverage.

7. Intrusive Sex - Boundary violation without discovery. Sexual arousal occurs by violating boundaries with no repercussions.

8. Anonymous Sex - High-risk sex with unknown persons. Arousal involves no seduction or cost and is immediate.

9. Pain Exchange Sex - Being humiliated or hurt as part of sexual arousal; or sadistic hurting or degrading another sexually, or both.

10. Exploitative Sex - Exploitation of the vulnerable. Arousal patterns are based on target ‘types’ of vulnerability.

Who does sex addiction affect?

Sex addiction affects all types of people from all cultural backgrounds and all economic classes because ultimately sex addiction is a coping mechanism in response to trauma or extreme stress in some area of one’s life, something that may be common to all classes and backgrounds. Both men and women can be sex addicts, although statistics guesstimate that only 8-12% of sex addicts seeking treatment are women. As you might imagine, there is a need for greater statistical information on the subject of sex addiction due to the evolving understanding and acceptance of this diagnosis. Still, for healthcare professionals to ignore the reality of the various types of sex addiction and corresponding professional treatments can do a grave injustice to any patient who struggles with this specific problem.

Questions about types of sex addiction

Please leave us your questions about sex addiction here. We will be happy to try to answer your questions personally and promptly, and/or refer you to sex addiction treatment when possible. All questions about sex addiction are welcomed.

Photo credit: kygp

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13 Responses to “Types of sex addiction
Wayne
3:18 pm February 11th, 2012

What is your analysis of swinging between to consensual adult couples. Would you consider it addictive behavior because of its existence or does there need to be some other pathological behavior prevelant to label it as addictive. If the practice of swinging produced positive changes in the relationships of the couples do you or the organizations that you are associated with have the autonomy to say so without political or religious retribution?

2:01 pm February 13th, 2012

And if swinging is a type of sex addiction is swinging a type of fantasy sex…or where else would this sexual behavior fall into the continuum of types of sex addiction?

Alex Katehakis
10:55 am February 17th, 2012

Swinging is not a sign of addictive behavior. As stated in the article, the criteria for addictive behavior includes obsession, compulsion, loss of control, and continuation despite negative consequences. For a sex addict, swinging could fit into many of the types listed above depending on the circumstances and the way the activity is being used to manage underlying pain or trauma, which is the cause of any sex addiction. Recovery would involve stopping the behavior for a while to treat the underlying trauma. But stopping the behavior for a sex addict is an involved process in and of itself.

Sexuality is personal, and I believe healthy sexuality is self-defined — as long as it does not involve abuse, exploitation, or manipulation. We hosted a lecture on Sexual Paraphilias recently where we underscored the necessity for a treating therapist to try not to pathologize any client’s paraphilia. We try to unpack this information, but not with the intent to change it unless it is the client’s desire to change (and when they desire to change, we also unpack any possible sense of repression around this.) Oftentimes a paraphilia is perfectly reasonable for a client given their history and their arousal template.

Not too long ago, homosexuality was widely considered to be a mental illness in the psychiatric community. The psychiatric community has reversed course, and I do not know anyone in the field who holds a negative view of homosexuality today although certainly there are political and religious institutions who do so, some of whom offer their own version of sex therapy. But the AASECT-Certified Sex Therapists (CST) and IITAP-Certified Sex Addiction Therapists (CSAT) that I’ve met respect the individual definition of sexuality with its wide spectrum of expression.

One aspect of unpacking that we would look at with couples who enjoy swinging might be the level of coercion or codependency in the relationship. Is this an authentic expression of sexuality for these two people? Is one trying to please the other in an effort to hold on to the relationship? What is the capacity for healthy intimacy between the couple? Swinging would probably not be recommended for anyone who identified as a sex addict, due to the nature of sex addiction but again this is something we unpack. Sexuality really is very personal and it is different for everyone — there is no “one size fits all.”

As far as publishing the positive changes in relationships due to swinging, that would be the work of researchers, although I am sure you can find plenty of sexologists who have published such statements. Among the certified therapists in my field, I don’t know anyone who fears “political or religious retribution.” It’s not really the role of the therapist to judge positive or negative sexual behavior, this would be more meaningful coming from the client’s own experience over time.

Big T
11:52 am March 26th, 2012

You mention homosexuality in your response above.

Would you consider homosexuality/Same Sex Attraction as a form of sex addiction?

Alex Katehakis
5:16 pm March 29th, 2012

Homosexuality or same sex attraction is not a form of sex addiction.

Anne
2:42 am May 4th, 2012

Alex,
I greatly enjoyed this article, thank you. Can you please verify the 1/4 million people searching for sex addiction information on Google monthly? Not that I doubt that it is true, it just seems difficult to quantify. How do they know it is individual people searching and not just searches?

As a recovery Sex Addict, I appreciate the descriptions of the different types of sex addiction. I was never compulsively promiscuous, but my fantasy addiction was enough to do me in!

12:17 pm May 10th, 2012

Hi Anne. Thanks for your question. To track search trends, you can look into a keyword based tool like Alexa keyword tools, Google AdWords, or the SEO Book Keyword Tool. These are free third party software that allow you to estimate how many people search for certain keywords such as “sex addiction” within a certain amount of time.

April
4:52 am June 8th, 2012

I am looking for a place for my boyfriend of 4 years to go to that will take our insurance. He works in a field that doesn’t take his type of addiction seriously. It is ruining our lives. I am suffering because of his addiction. It’s constant lies and porn and pictures of random women, websites for prostitutes, affairs, several email
Accounts, etc. I can’t take his addiction any longer.

5:15 am June 11th, 2012

Hi April. I’d suggest you check out the book: A Couple’s Guide to Sex Addiction. There are references and resources in the book, but you can also get informed yourself about sex addiction and understand more about what drives your boyfriend to this behavior…and how he can learn to be intimate. I truly hope that this helps, as sex addiction is one of the most misunderstood compulsive behaviors that can ruin lives. Please let me know what you think.

http://compulsionsolutions.com/couples-guide-to-sexual-addiction.html

Dr. Shannon Sticken
3:57 am November 21st, 2012

This is a great resource of the different types of sex addiction. As a Tucson Sex Addiction Therapist, I have worked with many individuals and couples who are dealing with these very issues. It is good to see that there are good resources about sexual addiction, such as this, that people can find on the internet. It is also good to read the above discussion to further elaborate on the definition and types of sex addiction as well.

tammy watson
5:13 pm February 11th, 2013

…was simply looking for the three degrees of addxn, and stumbled upon this work. …incredibly succinct!!! And by the looks of this list, I can’t help but wonder who is not effected. My sense is for those doing this work professionally, the sky is the limit. Of course, this is a “mixed bag,” as no one would wish any of these issues on another.
sincerely,
tammy

Sumera Farman
3:00 am March 13th, 2013

Can I get some recent statistics on how many addicts are men and how many are women. Also what percentage of these are of South Asian descent?

kara
12:17 am January 8th, 2014

Check out a movie called “Thanks For Sharing”. May or may not explain what truly is going on! Sex addicts are highly skilled and deceptive. They lead a secret life.

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About Alexandra Katehakis, MFT

Alexandra Katehakis, MFT is a Certified Sex Addiction Therapist/Supervisor, AASECT Certified Sex Therapist/Supervisor, and Clinical Director of the Center for Healthy Sex in Los Angeles, CA. She is the author of Erotic Intelligence: Igniting Hot Healthy Sex After Recovery From Sex Addiction. Please visit our website or contact (310) 843-9902 for more.